Prevention and Care Management

2008

The Maya Angelou Research Center on Minority Health at Wake Forest University Health Sciences Center used an AHRQ-funded health literacy tool to determine the level of health literacy among Spanish-speaking residents in Forsyth County, North Carolina.

The tool, called the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA), was developed with AHRQ funding by Shoou-Yih Daniel Lee, PhD, and his colleagues. The SAHLSA is designed to be easy for use in a clinic or community setting to screen for limited health literacy among Spanish speakers.

The SAHLSA was based on the Rapid Estimate of Adult Literacy in Medicine, which is accepted as the most easily administered tool for assessing health literacy in English. The SAHLSA also incorporates a comprehension test using multiple-choice questions in addition to the word-recognition test in the Rapid Estimate of Adult Literacy in Medicine.

Jorge Calles Escandon, MD, Associate Professor, Department of Internal Medicine/Endocrinology and Metabolism at Wake Forest University Health Sciences Center, directed the project. "The SAHLSA was applied to anyone who wanted to participate in locations where we could find Hispanics-churches, stores, and supermarkets. A Latino, fluent in English and Spanish, applied the test," he explains.

"SAHLSA got my attention since it is the very first validated tool to explore health literacy in Spanish using basic principles of the language, not just a translation of pre-existing tools," he continues. He likes the tool, noting that it would be even more useful if a computerized version were available.

Early results of the project revealed that age, gender, years in the U.S. or in North Carolina did not affect the outcome. However, not surprisingly, education level was a predictor of health literacy.

Calles Escandon plans to use the results to screen for literacy in patients who come to the County's hospitals and clinics for treatment. He and his colleagues will also conduct interviews after the assessments. The goal is to understand whether patients' prescriptions and/or lab orders are better understood as a function of their health literacy level.

The Angelou Center addresses the increasing diversity of the American population. By 2050, it is estimated that the U.S. will be divided almost evenly between non-Hispanic whites and all other minority groups.